Associations of substance use patterns with attempted suicide among persons who inject drugs: can distinct use patterns play a role?

TitleAssociations of substance use patterns with attempted suicide among persons who inject drugs: can distinct use patterns play a role?
Publication TypeJournal Article
Year of Publication2015
AuthorsArtenie AAdelina, Bruneau J, Zang G, Lespérance F, Renaud J, Tremblay J, Jutras-Aswad D
JournalDrug Alcohol Depend
Date Published2015 Feb 1
KeywordsAdult, Alcoholism, Central Nervous System Stimulants, Cohort Studies, Female, Humans, Male, Marijuana Abuse, Middle Aged, Odds Ratio, Prospective Studies, Quebec, Self Report, Social Environment, Socioeconomic Factors, Stress, Psychological, Substance Abuse, Intravenous, Substance-Related Disorders, Suicide, Attempted, Surveys and Questionnaires

BACKGROUND: While the elevated risk of suicide attempt among persons who inject drugs (PWID) is well documented, whether use of different substances is associated with varying degrees of risk remains unclear. We sought to examine the associations between substance use patterns and attempted suicide in a prospective cohort of PWID in Montreal, Canada.METHODS: Between 2004 and 2011, participants completed an interviewer-administered questionnaire eliciting information on socio-demographics, substance use patterns, related behaviors, and mental health markers. Generalized estimating equations were used to model the relationship between self-reported use of six common substances (cocaine, amphetamine, opioids, sedative-hypnotics, cannabis and alcohol), associated patterns of use (chronic, occasional and none), and a recent (past six-month) suicide attempt.RESULTS: At baseline, of 1240 participants (median age: 39.1, 83.7% male), 71 (5.7%) reported a recent suicide attempt. Among 5621 observations collected during follow-up, 221 attempts were reported by 143 (11.5%) participants. In multivariate analyses adjusting for socio-demographics and psychosocial stressors, among primary drugs of abuse, chronic [adjusted odds ratio (AOR): 1.97] and occasional (AOR: 1.92) cocaine use, and chronic amphetamine use (AOR: 1.96) were independently associated with attempted suicide. Among co-used substances, chronic sedative-hypnotic use was independently associated with an attempt (AOR: 2.29). No statistically significant association was found for the remaining substances.CONCLUSION: Among PWID at high risk of attempted suicide, stimulant users appear to constitute a particularly vulnerable sub-group. While the mechanisms underlying these associations remain to be elucidated, findings suggest that stimulant-using PWID should constitute a prime focus of suicide prevention efforts.

Alternate JournalDrug Alcohol Depend
PubMed ID25487226
Grant ListMOP135260 / / Canadian Institutes of Health Research / Canada
MOP210232 / / Canadian Institutes of Health Research / Canada